Analysis of tracheostomies in a Paediatric Intensive Care Unit during the period 2003–2013

Abstract Introduction Tracheotomy in paediatric patients is a rare procedure. In this paediatric series, perioperative complications, mortality related to surgical procedure and overall mortality are analysed. Patients and methods This is a retrospective study conducted from January 2003 to December 2013. Data were retrieved from patients who were tracheotomized and admitted to our PICU in the postoperative period. Results Data were collected from 25 tracheotomized patients admitted during the study period. The mean age was 31.3 months (median 14 months, range 1–144 months), and PICU length of stay was 53 days (median 37 days, range 1–338 days). Most patients (68%) had comorbidities prior to admission, with a higher prevalence of craniofacial anomalies/polymalformative syndromes (32%) and prematurity related disorders (12%) being observed. The most common aetiologies related to the procedure were congenital airway obstruction (16%) and several types of spinal cord injury (16%), followed by tracheobronchomalacia (12%) and subglottic stenosis (12%). Complications were detected in 40% of patients, with accidental decannulation being the most frequent. Accidental or unexpected decannulation occurred was present in as many as 20% of our patients, mainly in the first 24 h after surgery. One patient died as a result. Conclusions The postoperative course of a tracheotomy is associated with a high rate of complications, some of them related to life-threatening events.